Quiz 2 Flashcards
(40 cards)
What is pneumothorax?
accumulation of air in the pleural space causing partial or all of the lung to collapse
What is spontaneous pneumothorax? What are the two types?
air in the intrapleural space
no preceding trauma or underlying disease
primary: tall white slender males age 10-30 at higher risk
secondary: anyone can get it, patients with long term emphysema at risk
What is iatrogenic pneuomothorax?
caused by medical procedures
air in the pleural space
What is traumatic pneumothorax?
air in pleural cavity, can enter and leave
can lead to hemothorax and hemopneumothorax
penetrating
- can lead to tension pneumothorax
- due to penetrating wound
- GSWs and stab wounds
blunt
- car accident
What is hemothorax?
blood in pleural space from injury to chest wall, diaphragm, lung, blood vessels, or mediastinum
What is hemopneumothorax?
blood and air in the pleural space
What is chylothorax?
- lymphatic fluid in the pleural space
- seen in children often
risk factors
- post op thoracic sx
- congenital abnormalities of thoracic cavity
- empyema
What is tension pneumothorax?
- caused by trauma or disease
- air enters in the pleural space but can’t leave from penetrating injury
- leads to mediastinum shifts (CXR) and tracheal deviation and JVD
- heart becomes compressed–cardiogenic shock–death
What are the clinical manifestations of pneumothorax?
pleural pain
tachycardia
flared chest
dyspnea
respiratory distress
absent breath sounds
hyperresonance or dullness (trapped air)
subcutaneous emphysema
decreased cardiac output
What is subcutaneous emphysema?
- crepitus
- air accumulating in SQ tissue
- trapped usually in upper chest
What diagnostic studies are there for pneumothorax?
ABG - PaO2 < 80 mmHg
CXR - confirms
thoracentesis
What should a nurse tell a patient who is about to have a thoracentesis? What will the nurse do after?
pre- pt will feel pressure, but no pain
post- monitor status (VS, O2, inj. site)
What is the treatment for pneumothorax?
- spontaneous resolution
- urgent needle decompression (tension pneumothorax)
- thoracentesis
- chest tube (primary tx)
- pleurodesis (rx chemically destroys area that keeps rupturing–sealed)
What medications can be given for pneumothorax? Why?
Why should they be used cautiously?
benzodiazepines (lorazepam or midazolam)
opioid (norco - hydrocodone/acetaminophen)
used for treatments that can cause anxiety/pain
caution: can cause resp. depression
What are the nursing interventions for pneumothorax?
O2 therapy
semi-fowler’s
VS and lung sound monitor Q4
IV therapy for circulatory support
chest tube drainage care
respiratory/pulmonary consult
What is the order of supplemental oxygen devices?
Nasal cannula 2-6 L
Simple mask 6-10 L
Nonrebreather 10-15L
What is a chest tube?
catheter attached to drainage system
What does a chest tube do?
remove air or fluid from pleural and/or mediastinal space
re establish negative pressure
re-expand lung (primary goal)
What is a pigtail tube and heimlich valve?
one way system that allows air to exit pleural space
What are the components of a pleural drainage system?
collection chamber
water seal chamber
suction control chamber (wet or dry)
In the water seal chamber, what is tidaling? What does it indicate? What does it mean when there is no tidaling?
movement of fluid level with respirations (expected finding)
indicates proper function/patency
no tidaling = lung has re expanded
In the water seal chamber, how will one know if there in an air leak?
continuous bubbling = large leak
intermittent bubbling = air leak b/w pt and drainage system
In the suction control chamber for a wet suction system, what does the water do? How is it regulated?
uses water to control the amount of suction from the wall regulator
regulated by adding water to the suction control chamber
What does it mean when it is a dry system in suction control chamber? How is it regulated?
no water
self-regulated with an internal barometer
